PDF(Pubmed)
Abstract：
UNASSIGNED: Enhanced recovery after surgery (ERAS) protocols have been implemented to decrease opioid use and decrease patient hospital length of stay (LOS, days). Serratus anterior plane (SAP) blocks anesthetize the T2 through T9 dermatomes of the breast and can be applied intraoperatively. The purpose of this study was to compare postoperative opioid (OME) consumption and LOS between a control group, an ERAS group, and an ERAS/local anesthetic cocktail group in patients who underwent implant-based breast reconstruction.
UNASSIGNED: In this study, 142 women who underwent implant-based breast reconstruction between 2004 and 2020 were divided into Group A (46 patients), a historical cohort; Group B (73 patients), an ERAS/no-block control group; and Group C (23 patients), an ERAS/anesthetic cocktail study group. Primary outcomes of interest were postanesthesia care unit (PACU), inpatient and total hospital OME consumption, and PACU LOS.
UNASSIGNED: A significant decrease was observed from Group A to C in PACU LOS (103.3 vs. 80.2 vs. 70.5; p = 0.011), OME use (25.1 vs. 11.4 vs. 5.7; p < 0.0001), and total hospital OME (120.3 vs. 95.2 vs. 35.9; p < 0.05). No difference was observed in inpatient OMEs between the three groups (95.2 vs. 83.8 vs. 30.8; p = 0.212). Despite not reaching statistical significance, Group C consumed an average of 50-60 % less opioids per patient than did Group B in PACU, inpatient, and total hospital OMEs.
UNASSIGNED: Local anesthetic blocks are important components of ERAS protocols. Our results demonstrate that a combination regional block with a local anesthetic cocktail in an ERAS protocol can decrease opioid consumption in implant-based breast reconstruction.
UNASSIGNED: In this study, 142 women who underwent implant-based breast reconstruction between 2004 and 2020 were divided into Group A (46 patients), a historical cohort; Group B (73 patients), an ERAS/no-block control group; and Group C (23 patients), an ERAS/anesthetic cocktail study group. Primary outcomes of interest were postanesthesia care unit (PACU), inpatient and total hospital OME consumption, and PACU LOS.
UNASSIGNED: A significant decrease was observed from Group A to C in PACU LOS (103.3 vs. 80.2 vs. 70.5; p = 0.011), OME use (25.1 vs. 11.4 vs. 5.7; p < 0.0001), and total hospital OME (120.3 vs. 95.2 vs. 35.9; p < 0.05). No difference was observed in inpatient OMEs between the three groups (95.2 vs. 83.8 vs. 30.8; p = 0.212). Despite not reaching statistical significance, Group C consumed an average of 50-60 % less opioids per patient than did Group B in PACU, inpatient, and total hospital OMEs.
UNASSIGNED: Local anesthetic blocks are important components of ERAS protocols. Our results demonstrate that a combination regional block with a local anesthetic cocktail in an ERAS protocol can decrease opioid consumption in implant-based breast reconstruction.
摘要：
■已实施了增强手术后恢复（ERAS）方案，以减少阿片类药物的使用并减少患者住院时间（LOS，days).锯齿前平面（SAP）阻滞麻醉T2至T9的乳房皮区，可以在手术中应用。这项研究的目的是比较对照组之间的术后阿片类药物（OME）消耗和LOS，一个ERAS组,和ERAS/局部麻醉鸡尾酒组在接受基于植入物的乳房重建的患者中。
■在这项研究中，在2004年至2020年之间进行了基于植入物的乳房重建的142名妇女被分为A组（46名患者），历史队列；B组（73例患者），ERAS/无阻滞对照组；和C组（23例患者），ERAS/麻醉鸡尾酒研究组。感兴趣的主要结果是麻醉后监护病房(PACU)，住院和医院OME总消耗量，和PACULOS。
■在PACULOS中，从A组到C组观察到显着降低（103.3与80.2vs.70.5；p=0.011），OME使用（25.1与11.4vs.5.7；p<0.0001)，和总医院OME(120.3vs.95.2vs.35.9；p<0.05）。三组之间的住院OME无差异（95.2vs.83.8vs.30.8；p=0.212）。尽管没有达到统计意义，在PACU中，C组每位患者平均消耗的阿片类药物比B组少50-60%，住院,和总医院OME。
■局部麻醉阻滞是ERAS方案的重要组成部分。我们的结果表明，在ERAS方案中，局部阻滞与局部麻醉混合物的组合可以减少基于植入物的乳房重建中的阿片类药物消耗。
■在这项研究中，在2004年至2020年之间进行了基于植入物的乳房重建的142名妇女被分为A组（46名患者），历史队列；B组（73例患者），ERAS/无阻滞对照组；和C组（23例患者），ERAS/麻醉鸡尾酒研究组。感兴趣的主要结果是麻醉后监护病房(PACU)，住院和医院OME总消耗量，和PACULOS。
■在PACULOS中，从A组到C组观察到显着降低（103.3与80.2vs.70.5；p=0.011），OME使用（25.1与11.4vs.5.7；p<0.0001)，和总医院OME(120.3vs.95.2vs.35.9；p<0.05）。三组之间的住院OME无差异（95.2vs.83.8vs.30.8；p=0.212）。尽管没有达到统计意义，在PACU中，C组每位患者平均消耗的阿片类药物比B组少50-60%，住院,和总医院OME。
■局部麻醉阻滞是ERAS方案的重要组成部分。我们的结果表明，在ERAS方案中，局部阻滞与局部麻醉混合物的组合可以减少基于植入物的乳房重建中的阿片类药物消耗。
